Skin Cancer Keeps Changing My Lip Line

When I was in my twenties, my boyfriend's dermatologist father removed a few of my less beloved moles for cosmetic purposes. He did the standard biopsy, not expecting them to come back as cancer. But they did. Fortunately, they weren't melanoma, the most serious kind of cancer, but rather slow-growing basal cell cancers. He grimly said I was awfully young to be getting skin cancers of any kind.

Flashback: San Diego, early 1980s. I'm hanging out poolside with one of my junior-high friends. I'm complaining about how my pale, redheaded self only freckles and burns, never tans. She sternly tells me to stop whining; I'm not being disciplined enough in my sunbathing efforts. She puts me on a strict sun regimen involving silver reflective pads and baby oil.

That first diagnosis was 20 years ago, though, and I've lost count of how many cancers I've had removed. Dermatology techniques have improved. Some of my earliest cancers, on my arms and legs, seemed like they were scooped out with a melon baller. It took years for the keloid scars to flatten out. Now doctors have refined techniques to reduce scarring.

My sun damage is most severe in the area between my nose and lips. I've had three surgeries and one accident to this area. And every time I've gone through the process of wound care, stitch removal, healing, scarring and a slightly altered lip line.

The funny thing is, I look much worse for a few months after the surgeries than I do with the small, slightly scaly red cancer bumps. That's because basal cell cancers grow in 3D. While the part above the skin might be very small, there's no telling what kind of cancerous tentacles they're growing underneath, which is why the scars are usually bigger than the cancers.

Naturally, I've learned a few things about how to get through skin cancers and still look your best.

Look into Mohs surgery.

If your cancer is on your face, you want Mohs surgery. Instead of the old way of taking a big chunk of flesh in the hopes of getting it all at one go, Mohs surgery is precise. A highly-skilled Mohs surgeon takes the smallest margins possible, then puts a temporary bandage on you and sends you to the waiting room while the sample is analyzed on the spot. If they got it all, you come back in for your stitches. If not, they take more.

This can go on all day. But if the doctor is working on your face, it's worth spending the whole day so you're not left with a huge scar. These surgeons are experts at cutting and stitching so that you heal as perfectly as possible.

Live your life anyway.

Twice I've been stitched from a nostril all the way down to my inner lip. During healing, this looked like something purple dripping out of my nose and into my mouth. Gross? Yes. But I opted for my regular activities, rather than hiding in my room. Once I even wore a blue tiara to a party to match my blue stitches.

I felt really good about persevering, although the many people — both acquaintances and strangers — who said, "You're so brave to go out looking like that" didn't actually help.

Avoid traveling to certain areas right after surgery.

I learned not to travel to tropical, mosquito-heavy countries with a new wound. My first night in India, approximately 100 mosquitoes bit me, resulting in an unsightly infection. Domestic travel is better while in the early healing stages.

Don't try too hard with makeup.

Concealer and foundation are of limited usefulness when you have stitches or an obvious wound. Even when healing starts, makeup cakes and works its way into the nooks and crannies of scar tissue. It's obvious that I'm trying to hide something. Sometimes you just have to wear wounds, scars and scabs.

Better advice is to accent a different feature. When you look like an escapee from a horror-movie set. It's not like mascara and eyeshadow will fool anybody, but when the lower part of my face is damaged, applying eyebrow pencil, liner and mascara make me feel like I hadn't given up completely.

Then go subtle.

A light, translucent gloss is the most forgiving cosmetic for my ever-changing lip line. Lip liner looks like I'm trying too hard. As healing continues, lighter-colored lipsticks become feasible. If I'm in an extra-bold mood, I'll go red and play up what one artist friend called my Picasso-esque lip line.